Provider Demographics
NPI:1447296751
Name:RIORDAN, SUZANNE M (MSW)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:RIORDAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:THERESA
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2600 W 9TH ST # 3SW
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-2040
Mailing Address - Country:US
Mailing Address - Phone:610-565-6029
Mailing Address - Fax:
Practice Address - Street 1:2600 W 9TH ST # 3SW
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-2040
Practice Address - Country:US
Practice Address - Phone:610-565-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0132851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q63832Medicare UPIN
PA098542Medicare ID - Type Unspecified